Theory and design of "shortened" multiantenna microwave applicators with controllable SAR patterns

A "shortened" multiantenna hyperthermia applicator has been designed and tested at the Mallinckrodt Institute of Radiology at Washington University School of Medicine. By shortening the distance from antenna to aperture, an applicator is obtained that produces an SAR pattern that is essentially the same as produced by a monopole antenna. By placing several properly spaced probe antennas into the same "shortened" applicator, an applicator is obtained that produces a SAR distribution that is essentially a composite of small overlapping SAR patterns produced by weakly interacting incoherently driven antennas. Such a design significantly improves the applicator's lateral heating efficiency and allows the independent control of temperatures in certain tumor areas by changing the input power to the respective antennas.     

Comparison of measured and Monte Carlo calculated dose distributions in inhomogeneous phantoms in clinical electron beams

Calculations of dose distributions in heterogeneous phantoms in clinical electron beams, carried out using the fast voxel Monte Carlo (MC) system XVMC and the conventional MC code EGSnrc, were compared with measurements. Irradiations were performed using the 9 MeV and 15 MeV beams from a Varian Clinac-18 accelerator with a 10 x 10 cm2 applicator and an SSD of 100 cm. Depth doses were measured with thermoluminescent dosimetry techniques (TLD 700) in phantoms consisting of slabs of Solid Water (SW) and bone and slabs of SW and lung tissue-equivalent materials. Lateral profiles in water were measured using an electron diode at different depths behind one and two immersed aluminium rods. The accelerator was modelled using the EGS4/BEAM system and optimized phase-space files were used as input to the EGSnrc and the XVMC calculations. Also, for the XVMC, an experiment-based beam model was used. All measurements were corrected by the EGSnrc-calculated stopping power ratios. Overall, there is excellent agreement between the corrected experimental and the two MC dose distributions. Small remaining discrepancies may be due to the non-equivalence between physical and simulated tissue-equivalent materials and to detector fluence perturbation effect correction factors that were calculated for the 9 MeV beam at selected depths in the heterogeneous phantoms.     

Control of interstitial thermal coagulation: comparative evaluation of microwave and ultrasound applicators

This study presents a comparative evaluation of the control of heating and thermal coagulation with microwave (MW) and ultrasound (US) interstitial applicators. Helical coil MW antennas (17 mm and 25 mm length radiating antennae) were tested using an external implant catheter (2.2 mm o.d.) with water-cooling. US applicators with tubular transducers (2.2 and 2.5 mm o.d., 10 mm length, single-element and 3-element) were utilized with a direct-coupled configuration and internal water-cooling. Measurements of E-field distributions (for MW) and acoustic beam distributions (for US) were used to characterize the applicator energy output. Thermal performance was evaluated through multiple heating trials in vitro (bovine liver) and in vivo (porcine thigh muscle and liver) at varied levels of applied power (20-40 W for microwave, 15-35 W for ultrasound) and heating times (0.5-5 min). Axial temperature distributions in the tissue were recorded during heating, and dimensions of the resulting lesions of thermal coagulation were measured. Both MW and US applicators produced large volumes of tissue coagulation ranging from 8 to 20 cm3 with singular heating times of 5 min. Radial depth of lesions for both MW and US applicators increased with heating duration and power levels, though US produced notably larger lesion diameters (30-42 mm for US vs 18-26 mm for MW, 5 min heating). Characteristic differences between the applicators were observed in axial energy distribution, tissue temperatures, and thermal lesion shapes. MW lesions increased significantly in axial dimensions (beyond the active applicator length) as applied power level and/or heating duration was increased, and lesion shapes were generally not uniform. US provided greater control and uniformity of heating, with energy deposition and axial extent of thermal lesions corresponding to the length of the active transducer(s). The improved ability to control the extent of thermal coagulation demonstrated by the US applicators provides greater potential to target a specific region of tissue.     

The efficiency of clinical microwave applicators measured by a calorimetric method

When inducing localized hyperthermia for superficial cancer therapy with microwaves there has often been question about the total power output from the applicator. Although specific absorption rates and thermograms are used to obtain localized power distributions and heating patterns, these provide, at best, only an approximation of the total power applied to tissues or phantoms. In this paper a calorimetric technique for obtaining total microwave output power from applicators is described. An experimental apparatus was constructed and it was found to be accurate to approximately +/- 5 W. The power output from four clinical microwave applicators as a function of applied electric power was measured and the efficiency was found to be 40% in average. Along with enhancing quality assurance, the areas of hyperthermia research which may benefit the most from this calorimetric technique are computer modeling and patient treatment planning.     

Thermographically determined specific absorption rate patterns of 434-MHz applicators

The specific absorption rate (SAR) patterns of two 434-MHz hyperthermia applicators, models TCA 434-1 (9 X 20 cm) and TCA 434-2 (13 X 25 cm), were evaluated thermographically using a phantom model. The phantom model consisted of a 2-cm-thick layer of fat and a 10-cm depth of muscle contained in a 30 X 30 cm base Plexiglas box. The model was bisected in the middle. Polyester screens at the interface allowed the synthetic gel to make electrical contact between the two halves of the muscle tissue. Octyl alcohol was applied to the fat interface to ensure continuity of dielectric properties. Thermograms were taken for both applicators over the following areas of the exposed model: (1) fat surface, (2) internal surface with E-field parallel to interface, and (3) internal surface with E-field perpendicular to interface. SAR's were calculated from the temperature rise (8 degrees C maximum), net input power (550-650 W), exposure time (15-60 s), and specific heat of the muscle (0.86 kcal/kg degrees C). A factor of 0.42 needs to be multiplied to correct for the specific heat of fat. High localized SAR's along the broad sides of the applicators were seen when the applicators were in direct contact with the phantom. With the use of a 0.8-cm polystyrene foam spacing, the SAR's within the aperture of the applicators were relatively uniform. The patterns of the two applicators were quite similar. However, the TCA 434-1 applicator is smaller and more applicable for clinical conditions.     

Coordination and inhomogeneous activation of human arm muscles during isometric torques

1. In this study we have recorded the activity of motor units of the important muscles acting across the elbow joint during combinations of voluntary isometric torques in flexion/extension direction and supination/pronation direction at different angles of the elbow joint. 2. Most muscles are not activated homogeneously; instead the population of motor units of muscles can be subdivided into several subpopulations. Inhomogeneous activation of the population of motor units in a muscle is a general finding and is not restricted to some multifunctional muscles. 3. Muscles can be activated even if their mechanical action does not contribute directly to the external torque. For example, m. triceps is activated during supination torques and thus compensates for the flexion component of the m. biceps. On the other hand, motor units in muscles are not necessarily activated if their mechanical action contributes to a prescribed torque. For example, there are motor units in the m. biceps that are activated during flexion torques, but not during supination torques. 4. The relative activation of the muscles depends on the elbow angle. Changing the elbow angle affects the mechanical advantage of different muscles differently. In general, muscles with the larger mechanical advantage receive the larger input. 5. We have calculated the relative contributions of some muscles to isometric torques. These contributions depend on the combination of the torques exerted. 6. Existing theoretical models on muscle coordination do not incorporate subpopulations of motor units and therefore need to be amended.     

Dose measurements in inhomogeneous bone/tissue and lung/tissue phantoms for angiography using synchrotron radiation

For angiography using synchrotron radiation we measured the absorbed dose distribution in inhomogeneous phantoms with thin LiF:Mg, Cu, P, LiF:Mg, Ti thermoluminescent dosimeters (TLDs) in tissue and lung substitutes, and with Mg2SiO4:Tb TLDs in bone substitute for 33.32 keV monoenergetic photons from synchrotron radiation. The energy responses of the TLDs were measured in air for 10-40 keV monoenergetic photons. The values at 30 keV became smaller by 30% for LiF:Mg, Cu, P and larger by 22% for Mg2SiO4:Tb than the ratio of the mass energy absorption coefficients of the TLDs to that of air. These values were used to modify the calculated response of the TLDs in each phantom material. The absorbed dose distribution obtained was compared with that calculated using the Monte Carlo transport code EGS4 expanded to a low-energy region, and their agreement was confirmed taking linear polarization into account. In the bone substitute the dose increased by a factor of 3.9, while behind the bone the dose decreased drastically because of photon attenuation. In the lung substitute a slight dose difference from that in soft tissue was observed because of its different density. The LiF:Mg, Cu, P TLDs exhibited a better energy response, higher sensitivity and wider linear regions than did the other tissue-equivalent TLDs in the low-energy region.     

Numerical algorithm for dielectric-permittivity microwave imaging of inhomogeneous biological bodies

A two-dimensional microwave system is developed to explore the possibility of imaging the distribution of dielectric permittivity in an inhomogeneous biological body. A multiview approach is presented, which can notably improve the system's performance; it makes use of an illumination source that rotates jointly with the observation domain in which the scattered electric field is to be measured. The equation for inverse electromagnetic scattering is transformed into matrix form through the application of the moment method. A pseudoinversion algorithm is used to determine the distribution of the dielectric properties of the scattering body. A look-up table is devised to quickly form the final image. The results of some numerical simulations are reported to point out the capabilities and limitations of the method.     

An alternative method for determination of low-frequency specific absorption rate patterns in homogeneous phantoms

We propose a new application of voltage gradient measurements to determine specific absorption rate (SAR) at low frequencies where quasi-static electromagnetic conditions apply. This method, which we call the voltage gradient method, relies on direct measurement of the voltage field rather than measurement of the electric field or thermal transients. The voltage gradient method is fast and can be implemented with voltmeters of moderate cost. We tested the voltage gradient method using normal saline, in a phantom with simple geometry, and a sine wave voltage source at 5, 10, 20 and 50 kHz. Compared to the SAR measured thermally in the same phantom, the voltage gradient method produced almost identical curves when normalized. When the results of the voltage gradient method were scaled to the same power level used for the thermal SAR, the agreement was compatible with typical thermal SAR accuracy.     

Transfer and durability of acquired patterns of human arm stiffness

Previous studies have shown that the nervous system can produce anticipatory adjustments that alter the mechanical behavior of the arm in order to resist environmental disturbances. In the present paper, we focus on the ability of subjects to transfer acquired stiffness patterns to other parts of the workspace and on the durability of stiffness adaptations. To explore the transfer of stiffness control, subjects were trained at the left of the workspace to resist the effects of a single-axis disturbance that was applied by a robotic device. Following training, they were tested for transfer at the right. One group of subjects experienced similar torques at the left and right of the workspace, whereas the other group of subjects experienced similar forces at the hand. Following the initial training at the left, the observed orientation of the hand-stiffness ellipse rotated in the direction of the disturbance. In tests at the right, transfer was observed only when the direction of disturbance resulted in torques that were similar to those experienced during training. The results thus suggest that under the conditions of this experiment stiffness control is acquired and transfers in a joint- or muscle-based system of coordinates. A second experiment assessed the durability of an acquired stiffness pattern. Subjects were trained on 2 consecutive days to resist a single-axis disturbance. On a third day, the direction of the disturbance was switched by 90°. Substantial interference with the new adaptation was observed. This suggests that stiffness training results in durable changes to the neural signals that underlie stiffness control.     

Dosimetry of ruthenium-106 eye applicators.

In view of the importance of clinical applications of ruthenium-106 beta-ray sources for the treatment of choroidal melanoma, experimental, and theoretical approaches are presented for the dosimetry of such sources. The absolute dose and percentage depth dose of ruthenium applicators have been measured with an extrapolation ionization chamber. For a special flat applicator the absolute dose could be measured with an accuracy of +/- 5%, which is determined by the collection efficiency of the extrapolation chamber. The percentage depth dose of concave applicators, employed in the clinical situation, could only be measured at a distance larger than 5 mm due to their geometry and the outer dimensions of the extrapolation chamber. A computer simulation was therefore developed for the absorption and scattering of electrons, taking into account the geometry and materials of the applicator, to predict the percentage depth dose at distances smaller than 5 mm. The calculated and experimentally determined depth doses are in good agreement. With the aid of the computer simulation a depth dose determination for concave applicators can be made for clinically relevant distances less than 10 mm from the source surface with an absolute accuracy of +/- 10%.     

Thermal and SAR characterization of multielement dual concentric conductor microwave applicators for hyperthermia, a theoretical investigation

Six aperture array dual concentric conductor (DCO) microwave hyperthermia applicators were studied using theoretical models to characterize power deposition (SAR) and steady state temperature distributions in perfused tissue. SAR patterns were calculated using the finite difference time domain (FDTD) numerical method, and were used as input to a finite difference thermal modeling program based on the Pennes Bio-Heat Equation in order to calculate corresponding temperature distributions. Numerous array configurations were investigated including the use of different size DCC apertures (2, 3, and 4 cm), different spacing between apertures (1.0-2.0 cm), and different water bolus thicknesses (5-15 mm). Thermal simulations were repeated using blood perfusion values ranging from 0.5 to 5 kg/m3 s. Results demonstrate the ability of DCC array applicators to effectively and uniformly heat tissue down to a depth of 7.5-10 mm below the skin surface for a large number of different combinations of DCC element size, spacing, and water bolus thickness. Results also reveal the close correlation between SAR patterns and corresponding temperature distributions, verifying that design studies of the applicator can be performed confidently by analysis of SAR, from which the thermal behavior can be estimated. These simulations are useful in the design optimization of large microwave DCC array applicators for superficial tissue heating and for identifying appropriate aperture spacing and bolus thickness parameters for different size DCC aperture arrays and tissue blood perfusion conditions.     

Tomographic measurement of temperature change in phantoms of the human body by chirp radar-type microwave computed tomography

The chirp radar-type microwave computed tomograph (CT) measures the temperature change in a human body noninvasively. The paper examines its feasibility. A chirp pulse signal between 1 and 2 GHz is radiated from the transmitting antenna to the phantom. The transmitted waves are detected by the receiving antenna, which is place on the opposite side of the object, and the beat signal between the incident wave and the transmitted wave is produced by the mixer. By spectral analysis of the beat signal, only those signals transmitted on the straight line between the transmitting antenna and the receiving antenna are discriminated from multipath signals. The microwave tomogram can therefore be reconstructed easily using the conventional algorithms for an X-ray CT image. The microwave CT can use the chirp signal to remove the influence of multipath signals caused by diffraction and reflection. The imaging of dielectric materials with complicated structures is thus possible. The experimental results using phantoms show that the spatial resolution of this microwave CT is about 10 mm and that a two-dimensional distribution of temperature change can be measured.     

Optimization of a beam shaping bolus for superficial microwave hyperthermia waveguide applicators using a finite element method

Temperature inhomogeneity in hyperthermia treatments often limits the total thermal dose that can be delivered to the tumour region. To reduce such inhomogeneities, a prototype dynamically modifiable square array of saline-filled patches which attenuate microwave energy was developed for superficial treatments that use external microwave applicators. The array was situated inside the coupling water bolus that is often used with external applicators. The prototype has been previously tested clinically with promising results. A more complete theoretical analysis of the performance of this new bolus design and improvements to its design by modelling are presented here. The analysis was performed by performing five iterative simulations of the SAR pattern produced inside a tissue structure by a waveguide applicator with a water bolus containing the dynamic patch array attached. Between iterations the patch array configuration was modified in an attempt to improve the ability of the bolus to confine heating to an 'L'-shaped tumour region. These simulations were performed using the finite element method. The steady-state temperature profile was then computed using a finite element method based simulation of heat transfer that assumed a given applicator power level and water bolus temperature. Several iterations of these heat transfer simulations were performed with varying applicator power level and water bolus temperature to improve the confinement of heating to the target region. The analysis showed that the dynamic patch array should be capable of conforming heating to an 'L'-shaped target tumour region while limiting the heating to the surrounding normal tissue to an acceptable level.     

Anticipatory EMG patterns associated with preferred and non-preferred arm pointing movements

Rapid arm movements generate balance perturbations, which are anticipated and counteracted by postural adjustments. The effect of lateral preference on the control of the postural preparation to maximal velocity upperlimb pointing movements was investigated in right-handers. The muscular activities characterizing the postural adjustments were compared for preferred and non-preferred upper-limb movements. Movements were performed in two sitting conditions differing by their stability ("full on seat" and "edge of seat"). The electromyographic activity of the arm-movement prime mover and of several trunk and hip muscles involved in postural control was recorded with surface electrodes. Results indicate the presence of a reproducible pattern of anticipatory postural adjustments (APAs) involving trunk and hip muscles preceding the activation of the prime mover. In the "full on seat" condition, APAs started earlier and movement velocity was higher for preferred than for non-preferred arm movements. In the "edge of seat" condition, maximal velocity of movement did not differ significantly between both sides, but a higher excitation level of postural muscles was required to achieve this similar performance when the non-preferred upper limb was used. These findings are consistent with the hypothesis that handedness involves differences in the postural control associated with upperlimb movements, in other words that lateral preference is associated with a postural laterality.